Every day thousands of patients remove their shoes and/or socks before being weighed at a physician's office. Their bare or socked feet make contact with the surface of the scale often leaving behind foot powder, sweat, and potentially any of the many contagious foot diseases or fungal infections.
Because the feet are usually covered with socks and shoes, the skin of the foot is generally warm, dark, and moist. These three characteristics contribute to bacterial and fungal growth, often evident in the unpleasant smell of feet and the shoes covering them. While foot odor itself is not harmful, it can serve as a reminder that there are other, more aggravating foot conditions that can easily spread from person to person by fomite (i.e., inanimate objects, like scales, locker room floors, or shower stalls that are capable of transmitting infection from one person to another).
A few of the more common include dermatophytes such as Tinea and Onychomycosis that are fungal infections of the skin caused by dermatophytes, a diverse group of organisms that grow on humans as well as in soil and on animals. Transmission of dermatophytes may occur by direct person-to-person contact, by contact with animals or soil, or by contact with fomites.
Between 10% and 20% of the population worldwide is estimated to be infected with a dermatophyte. The most common clinical manifestation of dermatophyte infection is tinea pedis (also known as athlete's foot,) occurring in up to 70% of adults worldwide over a lifetime.
Not surprisingly, athlete's foot occurs commonly in athletes. A large European study revealed that 36.1% of sports-active individuals had evidence of fungal infection of the feet. Swimming pool users have been shown to have a high rate of dermatophyte infection, and marathon runners similarly have a high incidence of active and subclinical disease. Tinea pedis is the most common dermatophyte infection and is more common in males than in females. Increased incidence is related to hot humid weather and occlusive footwear is also believed to be a contributing factor.
Another common foot malady is Onychomycosis—a persistent fungal infection affecting the toenails and fingernails. Onychomycosis is most commonly found in people between the ages of 40 and 60 years. A typical reported incidence is between approximately 20 and 100 cases/1000 population. Toenail infection is typically four to six times more common than fingernail infection. Onychomycosis occurs more frequently in patients with common chronic medical problems such as diabetes and peripheral vascular disease, and in patients with any other conditions resulting in suppression of the immune system.
Still another condition is human papillomavirus (HPV) more commonly called warts. Warts are skin growths caused by human papillomavirus (HPV). The often painful plantar wart (verruca plantaris, on the bottom of the foot) and common wart (verruca vulgaris, on other skin surfaces) are the usual non-genital presentations. The principal sites are typically on the hands and feet, and they are a major cause of dermatological consultation. The HPV virus typically enters the body through skin abrasions. Transmission is believed to be by direct contact or by fomites. HPV infections of the skin are common, and most individuals are probably infected with one or more HPV types at some time.
Still another condition is arcoptes scabiei, better known as scabies. Human scabies is a highly contagious disease caused by the parasitic mite Sarcoptes scabiei. Fomite transmission is believed to be a major factor in passage of scabies.
Lesions of scabies are typically found in the finger webs, wrists, extensor surfaces of the elbows and knees, ankles, sides of the hands and feet, axillary areas, buttocks, and waist area.
Finally, Coxsackie virus (hand-foot-mouth disease or HFM) is a viral illness caused by Coxsackie viruses. HFM is characterized by lesions of the extremities (especially the feet and hands) and of the mucus membranes, especially the mouth. HFM is highly contagious and transmitted primarily by the fecal-oral route, but can also be isolated in the fluid from skin blisters. Although children are predominantly affected, adults are also at risk.
While physicians, nurses, other heath care professionals, and even patients typically wash and often disinfect their hands many times throughout the day to prevent the spread of germs and contaminants, little attention is often paid to the feet.
Patients are routinely weighed, ambulatory patients typically being weighted on a so-called platform scale. Such scales have a horizontal platform upon which the person being weighed is instructed to stand, typically without his or her shoes. The last patient of the day is instructed to make contact with an unprotected surface that every previous patient has contacted. This provides an opportunity for the spread of foot borne disease or other contamination.
Infants are typically weighed in a “cradle style” scale that is lined with disposable paper or other barrier designed to prevent the spread of germs. Also, each medical examination table is typically covered with paper or a similar barrier to also provide a sanitary surface for each new patient thereby also preventing the spread of germs or other contaminants.
It would, therefore, be desirable to provide a similar barrier for use with platform scales or other foot-receiving surfaces to likewise prevent the spread of germs or other contamination.